Parotid Surgery
What Are Parotid Glands?
The word parotid is derived from 'paraotic' which means 'beside or around the ear'. The two parotid glands are the largest among all salivary glands, located on either side of the mouth near the ear. These glands secrete saliva (channelled into the mouth through parotid duct) to keep the mouth and digestive system moist, lubricate the food passage, and break down carbohydrates.
How Do Parotid Gland Tumours Begin?
Parotid tumours (or neoplasms) in 80% of the cases are benign and malignant in the remaining 20%. These are caused by a number of factors like lymphatic malformations, workplace exposures to chemicals and radiations, HIV, weak immunity and metastasis. The practicing parotid surgeon Professor Stan Sidhu suggests that while benign parotid tumours are found in men and women above 40 years, their malignant form is usually diagnosed in women above 60.
What Is Parotidectomy?
Parotidectomy is the surgical procedure performed by a surgeon to partially or fully remove the parotid glands. Superficial parotidectomy is performed to remove just the lobe if the tumour is present just in the outer area of the glands. Total parotidectomy is required when the tumour spreads to the inner tissues and the entire gland must be removed.
Are There Any Risks And Complications Involved?
The most prominent risk involved in the procedure is that the parotid tumours are extremely close to the facial nerve. Temporary facial weakness may occur in 25-50% cases after the procedure when performed by a low volume parotid surgeon. The risk of permanent facial weakness is 1-2%. Other possible complications include Frey's syndrome(10%), bleeding,`` infection, seroma (collection of body fluid), sialocele (collection of saliva under the skin) and numbness of the ear.
As an experienced parotid surgeon, Professor Sidhu has performed hundreds of parotid surgeries over many years. Apart from reduced chances of complications, he is also an expert in handling any types of abnormalities during or after the procedure.
The Procedure
The parotid surgeon makes the incision in a skin crease in front of and behind the ear. Professor Sidhu specialises in minimally invasive surgery and can ensure that the resulting scar may be barely noticeable. The gland and the tissues to be removed are exposed by making a flap and a neuromonitor is used to minimise damage to the facial nerve. Professor Sidhu has a temporary facial nerve injury rate of 10-15% and a permanent nerve injury rate of <2%. There are many branches of the facial nerve and these have to be carefully dissected to minimise nerve injury.